降低有效的透压与心脏手术患者急性损伤增加有关
Phat T Dang1, Balbino E Lopez2, Kei Togashi3
1Anesthesiology and Perioperative Medicine, University of California Irvine Health, Orange, USA.
Cureus
|October 13, 2023
概括
较高的 perfusion 压力可能预测心脏手术后急性损伤 (AKI) 的风险较低. 监测腹腔内压力 (IAP) 和输液指数可以帮助识别有风险的患者.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心血管外科心血管外科
- 关键护理医学 关键护理医学
背景情况:
- 手术后急性损伤 (AKI) 是心脏外科手术的一个重大并发症.
- 腹内压力 (IAP) 可以影响器官输液,包括输液.
- 对 perfusion 的有效监测对于早期 AKI 检测至关重要.
研究的目的:
- 在接受心脏手术的患者中调查腹内压力 (IAP), perfusion 指数和术后 AKI 之间的关联.
- 评估透指数对AKI发展的预测价值.
主要方法:
- 一项前性队列研究,涉及成人患者接受心肺旁路开放心脏手术.
- 收集的数据包括腹内压力 (IAP),血液动力学参数和气道压力.
- 计算的脏 perfusion 指数:平均 perfusion 压力 (MPP),腹部 perfusion 压力 (APP) 和有效的脏 perfusion 压力 (eRPP).
主要成果:
- 没有发展AKI的患者在早期ICU停留期间具有较低的IAP和较高的 perfusion指数 (MPP, APP, eRPP).
- 较高的 perfusion 压力与术后 AKI 的可能性较低显著相关.
- AKI组经历了更长的ICU和住院时间.
结论:
- 透指数显示,透指数作为预测心脏手术术术后AKI的工具具有前景.
- 监测IAP和衍生的输液压可能有助于识别患有AKI风险的患者.
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